Healthcare Provider Details

I. General information

NPI: 1477244713
Provider Name (Legal Business Name): ELISE DIANE FRENCH BS, RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 E GALA ST STE 120
MERIDIAN ID
83642-4805
US

IV. Provider business mailing address

2020 S LUXURY LN APT G203
MERIDIAN ID
83642-4410
US

V. Phone/Fax

Practice location:
  • Phone: 208-315-6717
  • Fax: 208-315-6718
Mailing address:
  • Phone: 208-315-6717
  • Fax: 208-315-6718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number978919
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: